Cough Characteristics and Management in Sarcoidosis

Introduction to Sarcoidosis and Cough

The American Thoracic Society suggests that cough is a common and significant symptom in patients with sarcoidosis, affecting between 40% and 80% of symptomatic patients 1, 2

The pathogenesis of cough in sarcoidosis is related to inflammation of the granulomatous type in large and small airways, distortion of the parenchyma with endobronchial disease, extrinsic compression of the airways, and bronchial hyperreactivity, which is present in more than 50% of patients 1, 2
The American College of Chest Physicians notes that airway obstruction can be identified in more than half of the patients, regardless of smoking status 2

The European Respiratory Society indicates that nocturnal cough is commonly associated with other conditions such as asthma, upper airway cough syndrome, and gastroesophageal reflux disease 3, 4, 5
The American Academy of Pediatrics suggests that asthma is associated with nocturnal cough, although only one-third of children with isolated nocturnal cough have a disease similar to asthma 3, 4

The British Thoracic Society recommends that the primary treatment should be dictated by the specific disorder due to prognostic implications, and oral corticosteroids may improve symptoms, including cough, in patients with sarcoidosis 1, 2, 7, 8
However, the use of corticosteroids requires an individualized analysis of overall benefits and risks, as they may not have a lasting benefit and can be associated with significant side effects 7, 8, 9